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S Schachter

Publications and source records attributed to S Schachter.

At least 19 recordsLinked to original sources
PubMed2002

A double-blind, placebo-controlled study of remacemide hydrochloride in patients with refractory epilepsy following pre-surgical assessment.

This multicentre, randomised, double-blind, placebo-controlled, parallel-group study investigated the efficacy, safety and pharmacokinetics of remacemide hydrochloride in adult patients ( n= 59) with refractory epilepsy, undergoing reduced or discontinued antiepileptic drug (AED) usage, as part of an evaluation for epilepsy surgery. On discontinuation or reduction of maintenance AEDs, patients received remacemide hydrochloride, up to 600 mg daily, or placebo, for up to ten days or until they experienced a fourth complex partial (CPS) or a generalised tonic-clonic (GTC) seizure. Pre- and post-study blood and urine samples were taken for analysis. Remacemide hydrochloride showed a significantly ( P= 0.045) longer median time to fourth seizure compared with placebo (6.8 vs. 3.8 days). Median nine-day seizure counts were significantly ( P= 0.0327) lower with remacemide hydrochloride than placebo (6.2 vs. 12.8). Eleven remacemide hydrochloride patients and six placebo patients completed ten days' treatment. Remacemide and desglycinyl metabolite levels were lower in patients receiving concomitant carbamazepine or phenytoin than in those receiving non-inducing AEDs or remacemide hydrochloride alone. No serious adverse events occurred; all patients receiving remacemide hydrochloride completed the study. Remacemide hydrochloride was well tolerated and showed significant therapeutic activity in this patient population.

Acetamides↗
PubMed2001

Oxcarbazepine (Trileptal) as monotherapy in patients with partial seizures.

OBJECTIVE: To evaluate the efficacy and safety of oxcarbazepine (OXC) as monotherapy for patients with uncontrolled partial seizures. METHODS: A multicenter, double-blind, randomized, parallel-group, dose-controlled monotherapy trial compared OXC at 2400 mg/day with OXC at 300 mg/day in patients with uncontrolled partial-onset seizures previously receiving carbamazepine (CBZ) monotherapy. During a 28-day open-label conversion phase, patients were tapered off CBZ and titrated to OXC 2400 mg/day. After a 56-day open-label baseline phase on OXC 2400 mg/day, patients entered a 126-day double-blind treatment phase in which they were randomized to continue OXC at 2400 mg/day or were down titrated over 6 weeks to OXC at 300 mg/day. Patients met the efficacy endpoint by completing the double-blind treatment phase or by meeting one of four predefined exit criteria. The primary efficacy variable was time to meeting one of the exit criteria. The secondary efficacy variable was the percentage of patients meeting one of the exit criteria in each of the two treatment groups. RESULTS: Of the 143 patients enrolled, 96 were randomized in the double-blind treatment phase. Time to meeting an exit criterion was significantly in favor of the OXC 2400 mg/day group (p = 0.0001). The median time to meeting an exit criterion was 68 days for the OXC 2400 mg/day Group and 28 days for the OXC 300 mg/day Group. In addition, the percentage of patients meeting one of the exit criteria was significantly lower for the OXC 2400 mg/day Group (p = 0.0001). Overall, OXC was well tolerated with the most common adverse events consisting of fatigue, nausea, ataxia, and headache. CONCLUSION: This trial demonstrated that OXC at 2400 mg/day is well tolerated and efficacious when administered as monotherapy in patients with uncontrolled partial onset seizures.

Adolescent↗
PubMed2001

Terminal care and bereavement.

Care of patients at the end of life requires a high level of clinical vigilance, compassion and skill. The involvement of the patient's primary neurologist in end-of-life care and into bereavement can be an invaluable comfort to the patient and family. An understanding of the techniques for assessing and anticipating patient and family needs and knowledge of the resources available is essential if the neurologist is to provide guidance in their care.

Adult↗
PubMed2000

Laryngeal paralysis in cats: 16 cases (1990-1999).

OBJECTIVE: To determine clinical signs, physical examination findings, radiographic features, and concurrent diseases in cats with laryngeal paralysis, as well as evaluate the outcome of medical or surgical management. DESIGN: Retrospective study. ANIMALS: 16 cats. PROCEDURE: Medical records from January 1990 to April 1999 were examined for cats with laryngeal paralysis. Signalment, clinical signs, physical examination findings, cervical and thoracic radiographic findings, laryngeal examination results, and clinical outcome were reviewed. RESULTS: No breed or sex predilection was identified in 16 cats with laryngeal paralysis. The most common clinical signs included tachypnea or dyspnea, dysphagia, weight loss, change in vocalization, coughing, and lethargy. Clinical signs were evident for a median of 245 days. Airway obstruction was apparent on cervical and thoracic radiographic views in 9 cats. Examination of the larynx revealed bilateral laryngeal paralysis in 12 cats and unilateral laryngeal paralysis in 4 cats. The 4 cats with unilateral disease were managed with medical treatment, and 3 of these had acceptable long-term outcomes. Seven of 12 cats with bilateral paralysis underwent surgery; procedures performed included left arytenoid tie back, bilateral arytenoid tie back and ventriculo-cordectomy, and partial left arytenoidectomy. One cat was euthanatized as a result of complications from surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Laryngeal paralysis is an uncommon cause of airway obstruction in cats. Cats with less severe clinical signs (often with unilateral paralysis) may be successfully managed with medical treatment, whereas cats with severe airway obstruction (often with bilateral paralysis) may benefit from surgical intervention.

Airway Obstruction↗
PubMed2000

Vagus nerve stimulation therapy for epilepsy in older adults.

The authors assessed the efficacy, safety, and tolerability of vagus nerve stimulation (VNS) for refractory epilepsy in 45 adults 50 years of age and older. They determined seizure frequency, adverse effects, and quality of life. At 3 months, 12 patients had a >50% decrease in seizure frequency; at 1 year, 21 of 31 studied individuals had a >50% seizure decrease. Side effects were mild and transient. Quality of life scores improved significantly with time.

Electric Stimulation↗
PubMed1999

Telephone validation of the Quality of Life in Epilepsy Inventory-89 (QOLIE-89).

PURPOSE: To assess the psychometric properties of the Quality of Life in Epilepsy Inventory-89 (QOLIE-89) administered via telephone and to compare these properties with data gathered through self-administration. METHODS: A study of 139 patients with epilepsy was undertaken at three clinical sites in the United States. Patients participated in both telephone interview (T) and self-administration (S). Order effect was controlled through randomization (T-S and S-T). Twenty-eight S-T subjects participated in an assessment of the 2-week reproducibility of telephone interviews. RESULTS: Internal consistency and test-retest reliability levels of the QOLIE-89 overall score were very high across method of administration (T = 0.98; S = 0.98; ICC of T = 0.96). Scores were significantly related to mood (Profile of Mood States, r = -0.76, for both methods, p<0.001) and two indicators of epilepsy severity (seizure frequency in the past month, T: r = 0.52, p<0.0001; S: r = 0.54, p<0.0001; days since last seizure, T: r = 0.28, p<0.001; S: r = 0.25, p<0.01), with no significant differences in coefficients by method of administration. Performance of the measure was consistent for patients with unimpaired and impaired memory, using the Rivermead Behavioural Memory Test, and across level of education. CONCLUSIONS: Results of this study indicate telephone interview is a viable option for evaluating HRQL in persons with epilepsy and support the reliability and validity of the QOLIE-89 regardless of method of administration.

Adult↗
PubMed1996

Reduced stomach capacity in obese subjects after dieting.

The objective of the study was to assess the change in gastric capacity of obese subjects consuming a hypoenergetic diet. Otherwise healthy, obese subjects participated in a prospective controlled study as hospital outpatients. Fourteen (11 females, 3 males) subjects were assigned to the diet group and 9 (7 females, 2 males) were assigned to the control group. Subjects in the diet group were provided a 2508-kJ/d(600 kcal/d) formula diet for 4 wk. Subjects in the control group ate ad libitum for 4 wk. Gastric capacity was determined before the study and 4 wk later by oral insertion of a latex gastric balloon after an overnight fast. The balloon was infused with water at a rate of 100 mL/min, with pauses for measuring intragastric pressure, until no further distension was tolerated. Two indexes for estimating gastric capacity were used based on subjective and objective criteria: 1) the maximal volume that could be tolerated, and 2) the volume required to produce a rise in water pressure of 5 cm. Subjects in the diet group, who lost a mean of 9.1 kg, showed a 27% reduction in gastric capacity based on the first index (P = 0.004) and a 36% reduction based on the second index (P = 0.006). For the control subjects, gastric capacity did not change significantly with use of either index. The results demonstrate a reduction in gastric capacity in obese subjects after a restricted diet.

Adult↗
PubMed1995

EEG abnormalities in patients with atypical panic attacks.

BACKGROUND: Panic attacks and certain partial seizures have phenomenologic similarities which suggest that they may somehow be related. No evidence of such a relationship, however, was found when the routine EEGs of patients with panic attacks were examined. METHOD: Fifteen subjects with atypical panic attacks who met DSM-III-R criteria for panic disorder agreed to have routine followed by prolonged ambulatory EEG monitoring with sphenoidal electrodes. Fourteen subjects actually underwent monitoring; 1 had a panic attack during premonitoring routine EEG. RESULTS: Focal paroxysmal EEG changes consistent with partial seizure activity occurred during panic attacks in 33% (N = 5) of the 15 subjects; 2 (40%) of the 5 subjects with panic-related EEG changes had normal routine EEGs. Multiple attacks were recorded before panic-related EEG changes were demonstrated in several subjects. CONCLUSION: It may be necessary to monitor the EEG during multiple panic attacks to reveal an association between atypical panic attacks and epileptiform EEG changes.

Adult↗
PubMed1994

Markers of cerebral lateralization and alcoholism.

We assessed markers of anomalous cerebral dominance in 70 problem drinkers at risk for alcoholism, 43 alcoholics who had been sober for at least six months, and 311 healthy control subjects age-matched to the problem drinkers. Markers of anomalous cerebral dominance included left-handedness, learning disabilities, neuro-immune disorders, and special cognitive talents. We also administered a "drinking inventory" to assess frequency and severity of drinking patterns for self and family. Analysis showed elevated rates of left-handedness and learning disabilities in the alcoholic group and in the "at risk" problem drinkers. These same subjects rated themselves and their families as relatively poor at left-hemisphere-mediated cognitive talents. Alcoholic women evidenced significantly greater incidence of immune disorders than alcoholic men. Alcoholism appears to be related to biological factors which have been associated with anomalous cerebral dominance.

Adolescent↗
PubMed1994

Special talents in Geschwind's and Galaburda's theory of cerebral lateralization: an examination in a female population.

Geschwind and Galaburda (1985) proposed that delayed growth of posterior left hemisphere sites in male dyslexics are associated with markers of anomalous dominance (AD) and special cognitive talents. We found that talent in a female population was related to the strength of nonright-handedness, and was elevated in right-handed individuals with histories of familial left-handedness. Subjects reporting a history of dyslexia tended to be musically talented. While immune disorders were not related to talent for the whole population, they did co-occur with talents in a group of 10 individuals reporting 7 or more AD markers.

Adult↗
PubMed1993

Focal paroxysmal EEG changes during atypical panic attacks.

Atypical panic attacks include features such as focal paresthesias or sensory distortions, but attempts to demonstrate a relationship to partial seizures have been unsuccessful. Two patients with atypical panic attacks had attacks during EEG monitoring: one during a routine EEG in the EEG laboratory, the other at home during ambulatory monitoring. Focal paroxysms of sharp wave activity appeared on both patients' EEGs coincident with the spontaneous onset of panic attack symptoms. Both patients remained conscious. The correlation of focal paroxysmal EEG changes with panic attack symptoms suggests that these attacks were produced by partial seizure activity. Further study of the relationship between panic attacks and seizures is indicated.

Adult↗
PubMed1992

Cocaine decreases self-control in rats: a preliminary report.

Cocaine abuse is often associated with behavior that takes into account short-term, but not long-term consequences. However, there has been no empirical research concerning the effects of cocaine on self-control (choice of a larger, more delayed reinforcer over a smaller, less delayed reinforcer). In the present research, when food-deprived rats repeatedly chose between a larger, more delayed food reinforcer and a smaller, less delayed food reinforcer, chronic intraperitoneal injections of 15 mg/kg cocaine (but not 10 mg/kg fluoxetine) decreased the rats' choices of the larger, more delayed reinforcer. Cocaine can decrease rats' self-control.

Animals↗
PubMed1983

Medial thalamic hemorrhage with amnesia.

Three patients had amnesia and confusion as presenting features of thalamic hemorrhage. They had a relatively benign clinical appearance and lacked characteristics of the syndrome usually associated with thalamic hemorrhage. We reviewed hypotheses regarding a mechanism for the amnesic syndrome and concluded that lesions involving the medial thalamic nucleus were responsible for the amnesia observed.

Aged↗